SARS-CoV-2 RNA in serum as predictor of severe outcome in COVID-19

SARS-CoV-2 ( Severe Acute Respiratory Syndrome Coronavirus 2 ) causes COVID-19 ( Coronavirus disease 2019 ).

The aim of a study was to determine if SARS-CoV-2 RNA in serum at admission correlated with clinical outcome in COVID-19.

COVID-19 patients admitted to the Infectious Diseases department of a tertiary level Swedish hospital, and sampled for SARS-CoV-2 RNA in serum at admission, April 10 to June 30 2020 were included in a cohort.

Primary outcomes were day 28 all-cause mortality and progress to critical disease.

The cohort ( n=167 ) consisted of 106 SARS-CoV-2 RNA serum negative and 61 positive patients.

Median sampling time for initial SARS-CoV-2 in serum was 1 ( IQR 1-2 ) day after admission corresponding to day 10 ( IQR 8-12 ) after symptom onset.

Median ages were 53 ( IQR 44-67 ) and 63 ( IQR 52-74 ) years for the PCR-negative and positive patients, respectively.

In the serum PCR negative and positive groups 3/106 and 15/61 patients died, respectively.

The hazard ratios for critical disease and all-cause mortality were 7.2 ( 95% CI 3.0-17 ) and 8.6 ( 95% CI 2.4-30 ), respectively for patients that were serum PCR positive compared to serum PCR negative.

In conclusion, SARS-CoV-2 RNA in serum at hospital admission indicates a high-risk of progression to critical disease and death. ( Xagena )

Hagman K et al, Clin Infect Dis 2020; Online ahead of print